An uncontrollable bladder (OAB) can be stressful in someone’s life and a serious health issue.

Many factors can cause this condition; doctors say that weak pelvic muscles, nerve damage, specific medications, alcohol, caffeine, urinary tract infections, excess weight, and estrogen deficiency after menopause, are some of the main causes.

Dr Emile Rwamasirabo, a urologist at King Faisal hospital says that an overactive bladder is a genetic syndrome which is a combination of different symptoms, but its cause is unknown.

"The associated factors of this syndrome are very rare because this can be a syndrome that runs in the family; meaning a person can have it at any age and without any visible causes,” he says.

According to Healthline, OAB is more common in women over age 40 because the muscles controlling urination weaken over time. Factors contributing to weakened muscles include the physical pressure of pregnancy and childbirth.

Ernest Ingabire, Director of Rwanda Diabetes Association explains that frequent urination is also a sign of diabetes but if there are no other symptoms that point to diabetes, in this case, it’s the person’s kidneys that are not able to retain the urine, and this would always make them feel like going to the toilet every time.

He suggests visiting a doctor to make sure of what condition one is having.

Rwamasirabo explains that what happens when someone has an overactive bladder is that the contractions in their bladder, that help to overcome the tension to release the urine when full, are very weak.

"The bladder is made in a way that helps it to store urine and eliminate it for some time when needed. The contractions in the bladder are strong that they overcome the resistance of a full bladder, if the contractions are weak one will have the urge to frequently go to the toilet,” he says.

Overactive bladder occurs when the muscles of the bladder start to contract involuntarily even when the volume of urine in your bladder is low. These involuntary contractions create an urgent need to urinate, information from Healthline shows.

Possible causes of an overactive bladder include:

Neurological disorders such as stroke and multiple sclerosis diabetes

Urinary tract infections can cause symptoms similar to those of an overactive bladder

Hormonal changes during menopause in women

Abnormalities in the bladder, such as tumours or bladder stones

Factors that obstruct bladder outflow — enlarged prostate, constipation

Operations to treat other forms of incontinence

Rwamasirabo says that people who have had spine surgeries and too much consumption of coffee can also be associated with this.

Dr John Muganda Rwibasira, an obstetrician & gynaecologist says that suppressing urine cannot cause an overactive bladder but instead, it can cause a urinary tract infection.

Experts recommend doing these to overcome OAB;

Fluid and caffeine moderation/medication assessment. Symptoms of OAB will often not occur until a "critical” urinary volume is reached, and by limiting fluid intake, it will take a longer time to achieve this volume. 

Urgency inhibition. Reacting to the first sense of urgency by running to the bathroom needs to be substituted with urgency inhibition techniques. Stop in your tracks, sit, relax and breathe deeply. Pulse your pelvic floor muscles rhythmically to deploy your own natural reflex to resist and suppress urgency.

Timed voiding (for incontinence). Urinating by the "clock” and not by your own sense of urgency will keep your bladder as empty as possible. By emptying the bladder before the critical volume is reached (at which urgency incontinence occurs), the incontinence can be controlled. Voiding on a two-hour basis is usually effective, although the specific timetable has to be tailored to the individual in accordance with the voiding diary.

Pelvic floor muscle training (PFMT).  All patients need to understand the vital role of the pelvic floor muscles (PFM) in inhibiting urgency and frequency and preventing urge leakage. PFMT voluntarily employs the PFM to help stimulate inhibitory reflexes between the pelvic floor muscles and the bladder. Rhythmic pulsing of the PFM can inhibit an involuntary contraction once it starts and prevents an involuntary contraction before it even begins.